目的：评估数字化多媒体系统用于测量近距水平隐斜的可靠性。

方法：采用横断面诊断性试验研究，纳入2023年5月至2025年8月于汕头爱尔眼科医院就诊，主诉有视疲劳症状、行近视管理或常规眼科检查，并在此期间同期完成隐斜视检查的屈光不正患者； 所有配戴矫正眼镜的患者均以随机顺序接受数字化多媒体系统、Von Graefe法及Maddox Rod法检查，在0.4 m距离测量隐斜视度数，连续测量2次，通过组内相关系数(ICC)分析各方法的测量重复性，采用Bland-Altman法及Spearman相关分析评估数字化多媒体系统与两种传统方法的一致性。

结果：共纳入患者60例120眼，其中男27例，女33例，平均年龄21.03±7.24岁。重复性分析显示：数字化多媒体系统的ICC为0.960(95%CI：0.934-0.976)，Von Graefe法ICC为0.979(95%CI：0.964-0.987)，Maddox Rod法ICC为0.956(95%CI：0.926-0.973)，三种方法重复性均达优秀水平； Bland-Altman分析显示：Von Graefe法与数字化多媒体系统差值均值为0.367^△，95%一致性界限为-2.97^△-3.70^△，Maddox Rod法与数字化多媒体系统差值均值为0.067^△，95%一致性界限为-3.05^△-3.19^△； 两组差值均处于临床可接受范围(差值<4^△)，Spearman相关分析显示，数字化多媒体系统与Von Graefe法的相关系数r_s=0.867，与Maddox Rod法的相关系数r_s=0.777，均呈正相关(均P<0.001)。

结论：数字化多媒体系统在近距水平隐斜测量中具有较高的重复性，与传统Von Graefe法、Maddox Rod法具有良好一致性，有望为临床近距水平隐斜测量提供新的有效手段。

METHODS: This cross-sectional diagnostic study enrolled patients with refractive errors who visited Shantou Aier Eye Hospital from May 2023 to August 2025, presenting with symptoms of visual fatigue, undergoing myopia management, or receiving routine ophthalmic examinations, and who completed heterophoria testing during this period. All patients wearing full refractive correction underwent near-distance(0.4 m)horizontal heterophoria measurement in a random order using the digital multimedia system, the Von Graefe method, and the Maddox rod method. Two consecutive measurements were performed for each method. The intraclass correlation coefficient(ICC)was used to analyze the measurement repeatability of each method, and Bland-Altman analysis and Spearman correlation analysis were employed to evaluate the consistency between the digital multimedia system and the two traditional methods.

RESULTS: A total of 60 patients(120 eyes)were included, comprising 27 males and 33 females, with a mean age of 21.03±7.24 y. Repeatability analysis showed that the ICC for the digital multimedia system was 0.960(95%CI: 0.934-0.976), for the Von Graefe method was 0.979(95%CI: 0.964-0.987), and for the Maddox rod method was 0.956(95%CI: 0.926-0.973), all indicating excellent repeatability. Bland-Altman analysis revealed a mean difference of 0.367^△ \〖95% limits of agreement(LoA): -2.97^△ to 3.70^△\〗 between the Von Graefe method and the digital system, and a mean difference of 0.067^△(95% LoA: -3.05^△ to 3.19^△)between the Maddox rod method and the digital system. Both differences were within the clinically acceptable range(difference <4^△). Spearman correlation analysis showed positive correlations between the digital system and the Von Graefe method(r_s=0.867)and between the digital system and the Maddox rod method(r_s=0.777, all P<0.001).

CONCLUSION: The digital multimedia system demonstrates high repeatability and good consistency with the traditional Von Graefe and Maddox rod methods for measuring near-distance horizontal heterophoria. It shows promise as a new and effective tool for clinical near-distance horizontal heterophoria measurement.